The fight against social and territorial inequalities in the field of health starts with actually caring about them

Social and territorial health inequalities (ISTS) are a major pain in our system
health. They persist and expand again, both in the area of ​​health care provision
than in the health of the inhabitants of our country. In accordance with the Constitution of the Czech Republic
A fifth republic that takes over the preamble of the 1946 preamble, however, that should be the goal
the center of the nation.
At least in the long term, and despite appearances, we must clearly state the failure
public policy. It is not the result of a conspiracy: many men and women
at different levels of health care administration, not counting carers for whom it is essential
they even tried to actually fight over the years. However, along the way, they
they encountered, sometimes without realizing it or drawing all the implications
the contradiction between this goal and the economic system we live in, which aims to a
it contributes to the concentration of wealth in the hands of a few and on the other hand it is founded
negating the existence of social and territorial classes by hiding behind a standard
big universal statements.
In these failures we can also see the result of a misunderstanding of reality
social and territorial health among decision makers. Many live far from them. They don’t
don’t notice. However, since the 19th century, the work has accumulated year after year. They
they are at the birth of public health, the poor development of which we undoubtedly know in France
for the same reasons. However, the training of decision-makers basically ensures them
better knowledge of chronological development. It is because our bourgeois republic
was built on the idea of ​​progress, which justifies the endless effort to accumulate capital (z
all nature) in the hands of elites. This has driven development since the early 19th century
century, historical science and its teaching. As a former delegate said
Spatial Planning, Jean-Louis Guigou, “In France we are good at history, but we are
zero in geography and sociology »
. By “we” he meant those “in charge”
or who believes it. This is perhaps a simple reason for the failure.
Those who are not among these elites are well aware of the weight of these social determinisms and
territorial. They experience them every day in the tribulations of life. It is as shown
social history of our country, through their struggles, that the best changes are taking place almost
always. It must be the driving force behind public policies. So they should always
everywhere they establish public policies in all bodies with which they are connected, and
ask a few simple questions in the public square and demand answers
data. What the principle of public policy evaluation never really achieved,
they can achieve this by the obstinacy of their questions.
For this, all stakeholders, all users of the healthcare system could use the “Memo
ISTS” and ask for clear answers to the 12 questions it asks. A little
like aviators or surgeons make a checklist before flying or cutting.
Have this sustained interest in the issue of social and territorial health inequalities
would already represent an important step forward on the way to their treatment.

Health Inequalities: 12 Questions to Ask Yourself

  1. Analysis of the literature on the relationship between the given health issue
    and social and territorial inequalities in health, or have specific diagnoses
    was made? What are they saying? What are the main conclusions and what
    questioning determine?
  2. Is the work done to create a proposed action based on the data
    regarding differences in health levels and/or consumption data
    care by territory?
  3. Is it likely that the implementation of the planned program a priori will have counterproductive effects, will cause harm, regardless of their nature? She could
    advantage/disadvantage of a social group or territory that is already disadvantaged or
    vulnerable, especially in terms of access to prevention and health care?
  4. Could the recommended measure or intervention cause, directly or
    indirectly physical or mental health problems in certain groups of people
    population or in certain territories?
  5. Could the recommended action or intervention result in or promote?
    a lifestyle unfavorable to the health of certain population groups or v
    certain territories?
  6. Could the recommended measure or intervention jeopardize the main factors
    personal and family determinants for individual development of certain
    population groups or a certain territory or part of a territory, for example
    between center and periphery, on any scale?
  7. Could the recommended action or intervention limit access to services?
    basic social and health conditions of certain population groups or v
    certain territories?
  8. Could the recommended measures or interventions hinder social integration or
    challenge the security needs of certain population groups and v
    certain territories?
  9. Could the recommended action or intervention compromise the factors?
    economic development important and necessary for the well-being of certain groups
    population and in certain territories?
  10. The opinion, expectations, fears, prejudices of the various partners concerned
    have they been considered in all affected territories?
  11. Can the recommendation help reduce or increase STIs?
    In what proportion can we estimate this reduction and what is our goal?
    solid?
  12. Are the measures or recommendations proportionate to the identified vulnerabilities?
    resident and/or territory, that is, graduated, completed or modified in
    depending on the differentiated impacts they may have on categories of the population
    and territory?

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